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Updated: June 1, 2025
While a real atheroma generally causes a reduction in diastolic blood pressure, or at least but slight increase, he has found in syphilitic cases with arteriosclerosis a high diastolic pressure. If the blood pressure cannot be reduced by ordinary measures, arteriosclerosis is probably present.
When either general or local arteriosclerosis is present, the treatment which should be inaugurated comprises anything which would tend to inhibit the endarteritis and the classification necessary periods of rest, the interdiction of all physical effort or physical strain, and the regulation of the diet, digestion and elimination.
At this stage the heart, which has already shown some trouble, becomes unable to force the blood properly against this enormous resistance of inelastic vessels and the blood pressure begins to fail as the left ventricle weakens. Edema, failing heart, perhaps aneurysms, peripheral obstruction, or hemorrhages are the final conditions in this chronic disease of arteriosclerosis.
Probably often a myocarditis and perhaps some fatty degeneration are at the base of such a slowed heart after serious infections. A heart which has not always been slow but has gradually become slow with the progress of hypertension and arteriosclerosis will often disclose on postmortem examination serious lesions of the coronary arteries.
From the fact that lead poisoning causes an increased blood pressure, lead is a probable cause of arteriosclerosis. With the greater knowledge of the danger of poisoning possessed by those who work in lead, chronic lead poisoning is becoming rare, as evidenced by the lessening frequency of wrist drop and lead colic.
A subacute or a chronic infective endocarditis should be treated on the same plan as an acute endocarditis, which means rest in bed and whatever medication seems advisable, depending on the supposed cause of the condition. A chronic endocarditis which is part of a general arteriosclerosis requires no special treatment except that directed toward preventing the advance of the general disease.
If from any cause this hypertension persists, the muscular coats of the arteries will become more or less hypertrophied, and sooner or later degenerative changes begin in the intima, and finally fibrosis occurs in the external coat of the arteries; in other words, arteriosclerosis is in evidence.
The great range of uric acid diseases, such as rheumatism, calculi, arteriosclerosis, certain forms of diabetes and albuminuria, are due, on the one hand, to the excessive use of acid-producing foods, and on the other hand, to a deficiency in the blood of certain alkaline mineral elements, especially sodium, magnesium and potassium, whose office it is to neutralize and eliminate the acids which are created and liberated in the processes of starchy and protein digestion.
While arteriosclerosis often occurs coincidently with gout, and gout apparently may be a cause of arteriosclerosis, still the two diseases are widely dissociated, and the causes are not the same.
Hard physical labor and severe athletic work may cause arteriosclerosis to develop, and it is liable to develop in the arteries of the parts most used. Hypertension is generally a prelude to arteriosclerosis, and everything which tends to increase tension promotes the disease; everything which tends to diminish tension more or less inhibits the disease.
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